We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Long-term results of treatment of postradiation proctitis with argon plasma coagulation (APC).
- Authors
Kohut, Maciej; Gacek, Aneta; Gach, Barbara; Liszka, Łukasz; Bołdys, Hubert; Rymarczyk, Grzegorz; Romańczyk, Tomasz
- Abstract
Introduction: Postradiation proctitis (PRP) is a clinically significant complication after radiotherapy used for tumours of pelvic organs - mainly the prostate and the uterus. The leading clinical symptom is rectal bleeding. Aim of study: The assessment of effectiveness and safety of treatment with argon plasma coagulation (APC) of PRP in patients non responding to previous topical and/or oral anti-inflammatory treatment. Material and methods: All patients with PRP hospitalized in Department of Gastroenterology at Silesian Medical University and treated with APC between January 2000 - December 2004 were included to this retrospective study. Intensity of bleeding (5-grade scale) and endoscopic exponents of the activity of proctitis (3-grade scale) were assessed using appropriate classifications. Results: Radiotherapy was carried out for tumours of the prostate (3 cases), uterus (6 cases) and testes (1 case). Bleedings started on average 27 months (range 6-96) after radiotherapy. The intensity of rectal bleeding was assessed before and after the APC treatment. The division of the patients according to the three-grade Italian endoscopic scale of PRP was as follows: degree A - 1 patient, degree B - 5, degree C - 4. Two grade C patients required blood transfusions before APC. The number of APC sessions was as follows: grade A - 2; grade B - 1 to 4 (mean 2.4); degree C - 2 to 5 (mean 2.5). Within follow-up lasting on average 32 months (range 13-60) the intensity of rectal bleeding clinically significantly decreased in all patients (p<0.005). No patient required blood transfusion during follow-up. The mean haemoglobin level increased from 10.3 g/dl before APC to 11.5 g/dl two weeks after last treatment with APC (p=0.11). In 3 patients the immediate complications of APC were recorded: intensification of bleeding, which ceased after several days. In 3 patients late complications were found: clinically asymptomatic proctostenosis (2 cases) and formation of rectovaginal fistula (1 case). Conclusions: APC is an effective method of treatment in patients with PRP but the risk of complications should be carefully considered.
- Subjects
RADIOTHERAPY; PROSTATE cancer; UTERINE cancer; ARGON plasmas; PLASMA gases; BLOOD coagulation
- Publication
Gastroenterologia Polska / Gastroenterology, 2007, Vol 14, Issue 4, p261
- ISSN
1232-9886
- Publication type
Article